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Biomedical subjects

M R Fisher

Publications and source records attributed to M R Fisher.

At least 73 records · Page 4Linked to original sources
PubMed1984

Carpometacarpal dislocations.

Dislocations at the carpometacarpal joints are uncommon and can be overlooked due to the subtle nature of the radiographic findings. The diagnosis requires a proper understanding of the normal radiographic anatomy of the carpometacarpal joints. To aid in our understanding of the injury, anatomic dissections of the hand were performed. From these, we drew several conclusions about the mechanism of injury. Diagnostic criteria were then developed and applied in the review of a series of CMC dislocations. The incidence and diagnostic characteristics are presented. A systematic approach emphasizing the posteroanterior view and utilization of the parallel "M", principles of parallelism, symmetry, overlapping articular surfaces, and a distinct cortical rim are presented.

Adolescent↗
PubMed1984

Necrotizing sarcoid-like granulomatosis: radiologic-pathologic correlation.

Necrotizing sarcoid-like granulomatosis is one of five forms of pulmonary disease characterized histologically by angiitis and granulomata formation. Although there have been several reports of the clinical and pathological characteristics of the disease, there has been little reported radiographic correlation. We present two patients with necrotizing sarcoid-like granulomatosis with radiographic and pathologic correlation. The radiographic finding of diffuse lesions, either bilateral nodules or nodular densities with or without cavitation, should prompt definitive diagnostic evaluation. Tissue diagnosis is imperative as necrotizing sarcoid-like granulomatosis has a relatively good prognosis when compared with other similar granulomatous diseases.

Adolescent↗
PubMed1984

Prolapsing inflammatory pseudopolyp-fold complex of the oesophagogastric region.

This article describes a series of 12 adult patients in whom a prominent and mobile polypoid fold of the oesophagogastric region was demonstrated radiologically. Subsequent endoscopic and histopathologic studies confirmed the presence of an inflammatory pseudopolyp at the squamocolumnar junction and contiguous with a thick gastric rugal fold. The clinical and radiographic features of this entity and the mechanisms of its formation are reviewed.

Adult↗
PubMed1983

Lymphoma of the stomach following gastric surgery for benign peptic ulcers.

Adenocarcinoma of the gastric stump is a well-known complication of gastroduodenal surgery for benign lesions. However, we report 2 unusual cases wherein malignant lymphoma originated in the postoperative stomach. The first patient had undergone partial gastrectomy and Billroth II procedure 20 years earlier. The gastric lymphoma of the second patient manifested 39 years after vagotomy and pyloroplasty. In both instances, the tumor caused marked thickening and nodularity of the rugal folds without affecting the distensibility of the previously operated stomach. Differential diagnostic features of the observed findings and the potential carcinogenic effects of gastroduodenal surgery are reviewed.

Aged↗
PubMed1983

Computed tomography in the evaluation of the gluteal region.

The role of computed tomography (CT) in the evaluation of the gluteal region was assessed. Six cases of gluteal masses were studied preoperatively by CT; several were also studied with conventional radiographic methods, including barium enema, cystogram, and intravenous urogram. Our case material included an epithelioid sarcoma, Ewing's sarcoma, endodermal sinus tumor, cystic hygroma, neurofibromatosis, and a normal variant. The conventional radiologic studies were normal or demonstrated nonspecific soft tissue density mass effect. By comparison, CT, with its cross-sectional imaging capability, provided unique diagnostic information. CT depicted the presence and origin of a mass, provided tissue characterization, and showed the extent of the lesion, often demonstrating the gluteal mass as an extension of an intrapelvic lesion. CT was valuable in monitoring tumor response to therapy, detecting recurrences, and excluding normal variants as the cause for a gluteal mass. The information provided by CT was important in treatment planning.

Adolescent↗
PubMed1983

Systematic approach to identifying fourth and fifth carpometacarpal joint dislocations.

Dislocations of the carpometacarpal (CMC) joints are rare injuries which often have subtle radiographic findings that may be overlooked. A systematic approach for evaluation of the carpometacarpal joints is developed from analyzing the radiographic findings in 17 cases of CMC dislocations at the fourth and fifth CMC joints. Principles of parallelism, symmetry, overlapping articular surfaces, indistinct cortical rim, and parallel M lines are used in this evaluation. Ten patients had combined fourth and fifth CMC joint dislocations and seven had solitary dislocations at the fifth CMC joint. Most of these CMC dislocations are dorsal (71%). In combined fourth and fifth CMC joint dislocations, loss of parallelism and symmetry is observed at the fourth CMC joint with overlap identified primarily at the fifth CMC joint. Fracture of the fourth metacarpal base is often an associated injury. In solitary fifth CMC dislocations, slight ulnar offset of the fifth metacarpal on the hamate is the most consistent finding in association with loss of parallelism, symmetry, and overlap. Fracture of the radial margin of the fifth metacarpal base is often observed with solitary fifth CMC joint dislocations. A systematic approach and establishing the diagnosis from standard radiographic views is emphasized.

Adult↗
PubMed1982

Reliability of assessing change with sequential coronary angiography.

Data are presented from a study evaluating the reliability of sequential angiography in estimating changes in coronary lesions. Three panels of three expert angiographers each read on two separate, independent occasions 18 sets of paired angiograms taken 24 months apart. All readers were blinded to the temporal sequence of the films, clinical data, and ventriculography information. The need for simultaneous viewing and reading of the two films, for training sessions, and for allowance to be made for apparent differences arising from boundary definitions prior to final analysis was demonstrated. Under stringent conditions (determination of change based on agreement of at least two out of three panels of physicians) it was possible to ascertain change in coronary atherosclerosis from sequential sets of coronary angiograms with good reliability. However, single-panel readings yielded an unacceptable overestimate of the number of patients with lesion changes.

Coronary Angiography↗
PubMed1982

National Heart, Lung, and Blood Institute type II Coronary Intervention Study: design, methods, and baseline characteristics.

The Type II Coronary Intervention Study (Type II Study) is a double-blind, randomized, placebo-controlled clinical trial conducted by the Division of Intramural Research of the National Heart, Lung, and Blood Institute of Bethesda, Maryland. The study was designed to evaluate the 5-year treatment effect of cholestyramine on low density lipoprotein (LDL) cholesterol and on lesions in the coronary arteries. One hundred forty-three patients with Type II hyperlipoproteinemia (elevated LDL cholesterol) and coronary artery disease (CAD) were entered into the study between 1972 and 1976. Patients were stratified by sex and extent of coronary disease as defined angiographically and were randomly allocated to a daily dosage of 24 g cholestyramine and diet (treatment group) or placebo and diet (control group). Changes in the coronary arteries were evaluated by sequential coronary angiography carried out before and after five years of treatment. This report describes the trial design and baseline characteristics of the study patients.

Adult↗
PubMed1982

Evaluation of a new mobile automatic exposure control device.

Mobile chest radiographs obtained with manual technique and with an automatic exposure control device were compared in 50 patients requiring three radiographs within a 48 hr period. Parameters evaluated were overall quality, internal consistency, film latitude, lung field (consistency and quality), cardiac contour, hilar anatomy, pulmonary vascularity, mediastinum, tracheobronchial tree, and tubes and appliances. Radiographs obtained with the automatic exposure control system demonstrated better overall quality, consistency, film latitude, and lung field consistency and quality than manual technique. There was no definite advantage of the automatic exposure control device in the visualization of the hila, pulmonary vascularity, heart, or mediastinum. Tubes and appliances were seen equally well with both techniques. The automatic exposure control device has the potential to increase the quality and consistency of mobile radiographs, particularly in those critically ill patients who are radiographed at least on a daily basis.

Adult↗
PubMedDate not supplied

MR imaging of intramuscular hemorrhage.

This retrospective study was performed to (a) analyze the appearance of normal striated muscle using the spin echo (SE) technique and (b) evaluate the potential of magnetic resonance (MR) imaging for demonstrating intramuscular bleeding. Magnetic resonance examinations of 30 patients imaged for reasons other than muscular disorders were reviewed. Normal striated muscle was always imaged with a lower intensity than fat because muscle had a longer T1 and a shorter T2 than fat. Furthermore, the spin density of muscle was less than that of fat. The best contrast between the two tissues was obtained with a short repetition time (TR) of 0.5 s and a long echo time (TE) of 56 ms. In addition, five MR examinations from three patients with intramuscular bleeding were assessed. In one case the CT examination was also available for comparison. In every case MR permitted the diagnosis and demonstrated the precise extent of intramuscular bleeding and its regression after therapy. The MR diagnosis of intramuscular bleeding was readily performed because of the excellent contrast resolution of the technique. These lesions were always brighter than the surrounding normal muscle. The optimum SE technique, which enhanced contrast between the muscle and the site of bleeding, was a long TR of 2.0 s and a long TE of 56 ms. The T1 and T2 relaxation times of intramuscular bleeding were always longer than those of normal striated muscle. Preliminary results indicate that MR is very sensitive for the demonstration of intramuscular bleeding.

Adolescent↗
PubMedDate not supplied

MR imaging of an intrapericardial pheochromocytoma.

The magnetic resonance (MR) appearance of an intrapericardial pheochromocytoma is reported, and the role of MR, compared with CT and a 131I-metaiodobenzylguanidine scan in delineating masses from cardiac and vascular structures in the mediastinum is discussed.

3-Iodobenzylguanidine↗
PubMedDate not supplied

MR imaging of osteoid osteoma.

An osteoid osteoma was detected in a young boy with a classic history for this lesion. Plain radiography was not helpful but ultrasound and magnetic resonance imaging demonstrated the tumor nidus.

Child↗
PubMedDate not supplied

How far can a medial rectus safely be recessed?

Previous studies have suggested that the location of the equator should be important in determining the site of a "safe maximum recession" of a rectus muscle, and that the location of the equator should be a function of axial length. Exactly where in relationship to the equator a muscle can be safely recessed has never been scientifically determined. Over a 4-year period, we measured axial length on all patients we operated on for strabismus. Using a previously derived formula, we were able to calculate the limbus-to-equator distance, given axial length. Based on our analysis of 28 patients in whom we recessed one or both medial recti posterior to the equator, we believe that recessions of the medial recti up to 1.5 mm posterior to the equator should not produce postoperative medial rectus underaction associated with an overcorrection, but recessions that are further than 1.5 mm posterior to the equator may do so. Recessions to a point greater than 11 mm from the limbus do not appear to be associated with late progressive overcorrection provided that the site of recession is not greater than 1.5 mm posterior to the equator. Using our previously determined formula for estimating the location of the equator, given axial length, we have generated easy-to-use reference tables for determining the location of the equator in terms of millimeters posterior to the limbus. Also, based on axial length data from 180 strabismus patients, we have generated an algorithm for predicting axial length, given age, and refractive error, which may be useful to the strabismus surgeon in predicting the location of the equator when A-scan ultrasonography is not available.

Algorithms↗